Preliminary explorations of the effects of prior trauma and loss on risk for psychiatric disorders in recently widowed people

Background. This study compared the relative influence of childhood and adu lthood adversities on current diagnoses of Major Depressive Episode (MDE), Post-Traumatic Stress Disorder (PTSD) and Traumatic Grief (TG) among recent ly widowed older adults. Method. Eighty-five widowed persons were interview ed at a median of 4 months after their loss. The logistic regression proced ure was used to estimate the effects of three childhood adversities (parent al death, abuse, death of a sibling) and three prior adulthood adversities (death of a child, non-bereavement traumatic event, death of a sibling) on current diagnoses of MDE, PTSD and TG. Results. Adversities occurring in ch ildhood (abuse and death of a parent) were significantly associated with TG and, secondarily, MDE, while adversities occurring in adulthood (non-berea vement traumatic event and death of a child) were only significantly associ ated with PTSD. The tendency of childhood adversities to predict TG and adu lt adversities to predict PTSD remained significant even after the clusteri ng of adversities and comorbidity among psychiatric disorders were taken in to account. Conclusions. The results suggest that there is a vulnerability to TG rooted in childhood experiences explicitly, with more recent traumas having a stronger influence on PTSD secondary to widowhood. The distinctive etiological risks for bereavement-related PTSD, MDE, and TG suggest that t herapeutic approaches should be tailored to the particular syndrome(s) pres ent.